Nokea
A nurse is using Niagele9s rule to calculate the expected delivery date of a client who reports the first day of the last menstrual cycle was July 28th. Which of the following dates should the nurse document as a client expected delivery date? 07/28
- A. April 21st
- B. April 4th
- C. May 5th
- D. May 21st
Correct Answer: C
Rationale: The correct answer is C: May 5th. To calculate the expected delivery date using Naegele's rule, add 7 days to the first day of the last menstrual period (July 28th), then subtract 3 months, and add 1 year. July 28th + 7 days = August 4th. Subtract 3 months = May 4th. Add 1 year = May 5th. Choice A is incorrect as it is too early. Choice B is incorrect as it is also too early. Choice D is incorrect as it is too late.
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A client who is 16 weeks of gestation asks the nurse how to prepare her father to a younger sibling. Statements should the nurse make?
- A. You should hold your newborn in your arms when you introduce him to your toddler
- B. You should give your toddler a gift from the baby when she visits
- C. You should move your toddler out of her crib 2 weeks prior to your due date
- D. You should place your toddler in timeout if she exhibits regressive Behavior after the baby is born
Correct Answer: B
Rationale: Correct Answer: B - You should give your toddler a gift from the baby when she visits.
Rationale: Giving a gift from the baby to the toddler helps create a positive association and bond between the siblings from the beginning. It can also help the toddler feel special and included in the new family dynamic. This gesture can promote a sense of love and acceptance, easing the transition for both the toddler and the newborn.
Incorrect Choices:
A: Holding the newborn when introducing to the toddler may cause the toddler to feel overwhelmed or jealous.
C: Moving the toddler out of her crib close to the due date may disrupt her routine and lead to feelings of insecurity.
D: Placing the toddler in timeout for regressive behavior can create negative associations with the new sibling and cause emotional distress.
A nurse is assessing a client who is 27 weeks of gestation and has pre eclampsia. Which of the following findings should the nurse report to the provider?
- A. Hemoglobin 14.8 g/dL
- B. Platelet count 60,000/ mm
- C. Creatine 0.8 mg/ dL
- D. Urine protein concentration 200 mg/24hr
Correct Answer: B
Rationale: The correct answer is B: Platelet count 60,000/ mm. In pre-eclampsia, a low platelet count indicates thrombocytopenia, a serious complication that can lead to bleeding. This finding should be reported promptly to the provider for further evaluation and management. A: Hemoglobin level is within normal range and not a priority in pre-eclampsia. C: Creatinine level is normal and not directly related to the complications of pre-eclampsia. D: Urine protein concentration is elevated, which is expected in pre-eclampsia and should be monitored, but not as urgent as low platelet count.
A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique. Which of the following? - p170-171 - postprocedure bottom of 170 and goes into top of 171.
- A. The plastibell will be removed 4 hours after the procedure
- B. Notify the provider is the end of your penis appears dark red
- C. Make sure the newborn's diaper is snug
- D. Yellow exudate will form at the surgical site in 24 hours
Correct Answer: D
Rationale: The correct answer is D. Yellow exudate forming at the surgical site in 24 hours is expected after plastibell circumcision due to the healing process. This exudate consists of dead cells and is a normal part of wound healing. It is important for the parents to be aware of this so they do not mistake it for an infection or abnormality.
Explanation for other choices:
A: The plastibell is not removed after 4 hours; it falls off on its own in about 5-10 days.
B: Dark red appearance at the end of the penis could indicate a potential issue, but immediate notification of the provider is not necessary.
C: Ensuring the newborn's diaper is snug is unrelated to the circumcision technique.
E, F, G: No information provided.
A nurse is caring for a client who is receiving oxytocin to induce labor. The nurse should discontinue the oxytocin if which of the following occurs?
- A. Contractions last 60 Seconds
- B. Non-repetitive early decelerations
- C. 6 contractions in 10 minutes
- D. Moderate variability of the fetal heart rate
Correct Answer: C
Rationale: The correct answer is C: 6 contractions in 10 minutes. This indicates hyperstimulation of the uterus, putting the fetus at risk. Discontinuing oxytocin is necessary to prevent uterine tachysystole. Contractions lasting 60 seconds (choice A) are normal. Non-repetitive early decelerations (choice B) are benign. Moderate variability of the fetal heart rate (choice D) is a reassuring sign of fetal well-being.
A nurse is assessing a full-term newborn arm admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
- A. Transient circumoral cyanosis - i think this is referring to acrocyanosis which is normal
- B. Single Palmar creases - down syndrome - p.27
- C. Subconjunctival hemorrhage - expected
- D. Rust stain urine - expected
Correct Answer: B
Rationale: The correct answer is B: Single Palmar creases - down syndrome. This finding should be reported to the provider because it is a physical characteristic associated with Down syndrome. The presence of a single palmar crease can indicate a chromosomal abnormality and requires further evaluation.
A: Transient circumoral cyanosis is a common finding in newborns and is typically related to acrocyanosis, which is considered normal in the immediate postnatal period.
C: Subconjunctival hemorrhage is a common occurrence during the birth process and is often benign, resolving on its own without intervention.
D: Rust stain urine may be a result of uric acid crystals and is considered expected in newborns due to the metabolism of fetal hemoglobin. It does not typically require immediate reporting to the provider.
In summary, the other choices are considered normal or expected in newborns, while the presence of a single palmar crease requires further assessment due to its association with Down syndrome.